| Department File Number : | M201573969 |
| Claim Number : | 172326 |
| Date Submitted : | 7/7/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PROASSURANCE CASUALTY COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 38-2317569 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Joe | H | Grasse | ||
| Street Address | |||||
| 100 Brookwood Place | |||||
| City | State | Zip | |||
| Birmingham | AL | 35209 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (205) 439 - 7969 | jgrasse@proassurance.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Isaac | Bassan | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 4302 Alton Road, Suite 850 | ||||
| City | State | Zip Code | County | ||
| Miami Beach | FL | 33140 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| MP61161 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME38974 | Gastroenterology - Minor Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Dade | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Emergency Room | |||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/26/2008 | 6/28/2011 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Alleged failure to timely diagnose and treat perforated diverticulum, resulting in death six months after discharge. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Alleged failure to timely diagnose and treat perforated diverticulum, resulting in death six months after discharge. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Alleged failure to timely diagnose and treat perforated diverticulum, resulting in death six months after discharge. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/5/2012 | 12-08526CA20 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 3/11/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| Columbia Hospital Corporation of Miami Beach, Inc. Aventura Hospital and Medical Center Bloom, Michael L Korn, David J Aventura Heart Center, LLC | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Claim or suit abandoned. | |||||
| Final Method of Claim Disposition | |||||
| No Payment Made | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $31,027 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $9,634 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| N/A | |||||||||||||||||||||
| Updates | ||||||||||
| Date of Change: | 4/23/2015 3:15:45 PM | |||||||||
| Reason for Change: | Updated Financials | |||||||||
| ||||||||||
| Date of Change: | 7/6/2015 10:56:10 AM | |||||||||
| Reason for Change: | updated ALAE information | |||||||||
| ||||||||||
| Date of Change: | 7/7/2015 11:12:09 AM | |||||||||
| Reason for Change: | update ALAE | |||||||||
| ||||||||||
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. ISAAC BASSAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ISAAC BASSAN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).